Melanoma: What You Need to Know to Protect Yourself

It’s skin cancer awareness month and therefore a perfect time to review what you need to know to prevent melanoma.

Melanoma is the deadliest of the many types of skin cancer, and is also one of the only types of any cancer overall that is largely preventable.

One in 58 people will eventually be diagnosed with melanoma, and one American dies of melanoma almost every hour (every 61 minutes). The incidence of melanoma has been steadily increasing for the past 30 years. Since 1992, melanoma has increased 3.1 percent annually in non-Hispanic caucasians, but in recent years is increasing more rapidly.

Mortality from melanoma has stabilized in recent years, but the number of cases has increased. A multitude of factors contribute to these rates, including increased awareness, more people performing skin self-exams to look for suspicious moles, earlier detection, and attention to the link between indoor tanning and skin cancer, including melanoma. Risk factors for melanoma include:

-Exposure to ultraviolet light, from the sun and indoor tanning devices

The most effective tools for fighting melanoma may be preventing the disease altogether — or catching it and treating it in the early stages — but a number of new treatments and emerging research has also improved the outcomes for patients with advanced or metastatic melanoma

Dermoscopy and confocal microscopy are two new noninvasive technologies designed to help increase the sensitivity of the diagnosis of skin cancer lesions.

Dermoscopy uses microscope and light technology to look at skin lesions without reflection from the skin itself. Confocal microscopy allows physicians to perform non-invasive skin imaging on the cellular level. A review of the literature, coupled with anecdotal experience from practicing dermatologists, demonstrates both of these techniques are useful tools to augment the diagnosis of suspicious skin lesions, and are noninvasive.

Melanomas are typically removed surgically – the tumor is removed as well as some of the surrounding tissue to make sure it is all out. The amount of tissue removed depends on the size and depth of the tumor. In the setting of metastatic disease, the treatment is more involved and the types of treatments available are rapidly expanding and growing. In 2011, the FDA approved two new, targeted therapies for metastatic melanoma — vemurafenib (Zelboraf) and ipilimumab (Yervoy). These drugs represent significant advances for patients with metastatic melanoma, although there is still much work to be done. Up until a couple of years ago, there was nothing that was effective that we could offer people with advanced melanoma. While there are definitely some things to offer now, it’s still far from a cure.

Two other inhibitor medications in development are showing positive initial results for melanoma. Dabrafenib is a selective BRAF kinase inhibitor and trametinib is a MEK inhibitor. The data to date shows both of these drugs increased survival rates, and dabrafenib has also demonstrated high clinical activity in patients with brain metastases.

Dabrafenib and trametinib can be used in combination; the results of Phase I and II trials published in the New England Journal of Medicineshow combination therapy was safe at full monotherapy doses with significant improvement in survival time. While there is some evidence that these drugs do increase or prolong survival by a few months, a combination approach to therapy of patients with metastatic melanoma is certainly needed.

Early detection is key but prevention is even more important as MELANOMA IS THE MOST PREVENTABLE FORM OF CANCER! Sun exposure is the most preventable risk factor for skin cancer, and all physicians should be counseling their patients on sun protection:

-Use SPF 30 broad spectrum sunscreen and be generous in applying it to your skin – most people apply only 20 percent to 30 percent of what they should.

-Use a lip balm with an SPF of at least 30.

-Understand that sunscreen alone is not enough to protect you from skin cancer – seek shade during peak hours, 10AM to 4PM, and wear hats, sunglasses, and protective clothing if possible.

-Toss your old sun protection products – sunscreens have expiration dates but if you even have a question, dump it

-Children, especially babies, are extremely sensitive to UV radiation. Children under the age of 6 months should not have sunscreen applied to their skin. Older then 6 months, I recommend a product with a physical blocker such as titanium dioxide or zinc oxide. Sun protection starts at day 1!

To stay in the know on all thing melanoma, follow the Melanoma Research Alliance (MRA) on Twitter (@MelanomaReAlli) and Facebook. The goal of this non-profit organization is to raise money to support cutting edge research that will put an end to melanoma and to provide YOU with the most up to date and relevant information on skin cancer prevention and treatment. Join them in the fight against melanoma!

Get the latest health updates

Thanks for signing up!

Oops!

A system error was encountered. Please try again later.

Follow us on your favorite social network!

ABOUT THE AUTHOR

Adam Friedman, MD

Adam Friedman, MD, FAAD is an Associate Professor of Dermatology and serves as Residency Program Director and Director of Translational Research in the Department of Dermatology at The George Washington...read more

SEARCH ALL COLUMNS

This site complies with the HONcode standard for trustworthy health information: verify here.

Advertising Notice

This Site and third parties who place advertisements on this Site may collect and use information about
your visits to this Site and other websites in order to provide advertisements about goods and services of
interest to you. If you would like to obtain more information about these advertising practices and to make
choices about online behavioral advertising, please click here.